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description Publicationkeyboard_double_arrow_right Article 2019Publisher:Springer Science and Business Media LLC Funded by:UKRI | University of Birmingham ..., WT | Cerebellar-cortical inter..., WT | Institutional Strategic S... +1 projectsUKRI| University of Birmingham Confidence in Concept ,WT| Cerebellar-cortical interactions in health, aging and disease. ,WT| Institutional Strategic Support Fund Phase2 FY2014/16 ,UKRI| Performance-based selective training for robot-mediated upper limb motor learning and stroke rehabilitationRosenthal, Orna; Wing, Alan M.; Wyatt, Jeremy L.; Punt, David; Brownless, Briony; Ko-Ko, Chit; Miall, R. Christopher;Background Intensive robot-assisted training of the upper limb after stroke can reduce motor impairment, even at the chronic stage. However, the effectiveness of practice for recovery depends on the selection of the practised movements. We hypothesized that rehabilitation can be optimized by selecting the movements to be practiced based on the trainee’s performance profile. Methods We present a novel principle (‘steepest gradients’) for performance-based selection of movements. The principle is based on mapping motor performance across a workspace and then selecting movements located at regions of the steepest transition between better and worse performance. To assess the benefit of this principle we compared the effect of 15 sessions of robot-assisted reaching training on upper-limb motor impairment, between two groups of people who have moderate-to-severe chronic upper-limb hemiparesis due to stroke. The test group (N = 7) received steepest gradients-based training, iteratively selected according to the steepest gradients principle with weekly remapping, whereas the control group (N = 9) received a standard “centre-out” reaching training. Training intensity was identical. Results Both groups showed improvement in Fugl-Meyer upper-extremity scores (the primary outcome measure). Moreover, the test group showed significantly greater improvement (twofold) compared to control. The score remained elevated, on average, for at least 4 weeks although the additional benefit of the steepest-gradients -based training diminished relative to control. Conclusions This study provides a proof of concept for the superior benefit of performance-based selection of practiced movements in reducing upper-limb motor impairment due to stroke. This added benefit was most evident in the short term, suggesting that performance-based steepest-gradients training may be effective in increasing the rate of initial phase of practice-based recovery; we discuss how long-term retention may also be improved. Trial registration ISRCTN, ISRCTN65226825, registered 12 June 2018 - Retrospectively registered, Electronic supplementary material The online version of this article (10.1186/s12984-019-0513-0) contains supplementary material, which is available to authorized users.
Europe PubMed Centra... arrow_drop_down Europe PubMed CentralArticle . 2019Full-Text: http://europepmc.org/articles/PMC6466732Data sources: PubMed CentralJournal of NeuroEngineering and RehabilitationArticle . 2019Full-Text: http://europepmc.org/articles/PMC6425657Data sources: PubMed CentralJournal of NeuroEngineering and RehabilitationArticle . 2019 . Peer-reviewedLicense: CC BYData sources: Crossrefadd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.All Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=10.1186/s12984-019-0521-0&type=result"></script>'); --> </script>
For further information contact us at helpdesk@openaire.euAccess Routesgold 8 citations 8 popularity Top 10% influence Average impulse Top 10% Powered by BIP!more_vert Europe PubMed Centra... arrow_drop_down Europe PubMed CentralArticle . 2019Full-Text: http://europepmc.org/articles/PMC6466732Data sources: PubMed CentralJournal of NeuroEngineering and RehabilitationArticle . 2019Full-Text: http://europepmc.org/articles/PMC6425657Data sources: PubMed CentralJournal of NeuroEngineering and RehabilitationArticle . 2019 . Peer-reviewedLicense: CC BYData sources: Crossrefadd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.All Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=10.1186/s12984-019-0521-0&type=result"></script>'); --> </script>
For further information contact us at helpdesk@openaire.eudescription Publicationkeyboard_double_arrow_right Article 2017Funded by:WT | Cerebellar-cortical inter..., UKRI | Performance-based selecti..., WT | Institutional Strategic S... +1 projectsWT| Cerebellar-cortical interactions in health, aging and disease. ,UKRI| Performance-based selective training for robot-mediated upper limb motor learning and stroke rehabilitation ,WT| Institutional Strategic Support Fund Phase2 FY2014/16 ,UKRI| University of Birmingham Confidence in ConceptOrna, Rosenthal; Alan M, Wing; Jeremy L, Wyatt; David, Punt; R Chris, Miall;pmid: 29208020
pmc: PMC5718133
Background Chronic upper limb motor impairment is a common outcome of stroke. Therapeutic training can reduce motor impairment. Recently, a growing interest in evaluating motor training provided by robotic assistive devices has emerged. Robot-assisted therapy is attractive because it provides a means of increasing practice intensity without increasing the workload of physical therapists. However, movements practised through robotic assistive devices are commonly pre-defined and fixed across individuals. More optimal training may result from individualizing the selection of the trained movements based on the individual’s impairment profile. This requires quantitative assessment of the degree of the motor impairment prior to training, in relevant movement tasks. However, standard clinical measures for profiling motor impairment after stroke are often subjective and lack precision. We have developed a novel robot-mediated method for systematic and fine-grained mapping (or profiling) of individual performance across a wide range of planar arm reaching movements. Here we describe and demonstrate this mapping method and its utilization for individualized training. We also present a novel principle for the individualized selection of training movements based on the performance maps. Methods and Results To demonstrate the utility of our method we present examples of 2D performance maps produced from the kinetic and kinematics data of two individuals with stroke-related upper limb hemiparesis. The maps outline distinct regions of high motor impairment. The procedure of map-based selection of training movements and the change in motor performance following training is demonstrated for one participant. Conclusions The performance mapping method is feasible to produce (online or offline). The 2D maps are easy to interpret and to be utilized for selecting individual performance-based training. Different performance maps can be easily compared within and between individuals, which potentially has diagnostic utility. Electronic supplementary material The online version of this article (10.1186/s12984-017-0335-x) contains supplementary material, which is available to authorized users.
Europe PubMed Centra... arrow_drop_down Europe PubMed CentralArticle . 2017Full-Text: http://europepmc.org/articles/PMC5718133Data sources: PubMed Centraladd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.All Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=PMC5718133&type=result"></script>'); --> </script>
For further information contact us at helpdesk@openaire.eu1 citations 1 popularity Average influence Average impulse Average Powered by BIP!visibility 1visibility views 1 Powered bymore_vert Europe PubMed Centra... arrow_drop_down Europe PubMed CentralArticle . 2017Full-Text: http://europepmc.org/articles/PMC5718133Data sources: PubMed Centraladd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.All Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=PMC5718133&type=result"></script>'); --> </script>
For further information contact us at helpdesk@openaire.eu
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description Publicationkeyboard_double_arrow_right Article 2019Publisher:Springer Science and Business Media LLC Funded by:UKRI | University of Birmingham ..., WT | Cerebellar-cortical inter..., WT | Institutional Strategic S... +1 projectsUKRI| University of Birmingham Confidence in Concept ,WT| Cerebellar-cortical interactions in health, aging and disease. ,WT| Institutional Strategic Support Fund Phase2 FY2014/16 ,UKRI| Performance-based selective training for robot-mediated upper limb motor learning and stroke rehabilitationRosenthal, Orna; Wing, Alan M.; Wyatt, Jeremy L.; Punt, David; Brownless, Briony; Ko-Ko, Chit; Miall, R. Christopher;Background Intensive robot-assisted training of the upper limb after stroke can reduce motor impairment, even at the chronic stage. However, the effectiveness of practice for recovery depends on the selection of the practised movements. We hypothesized that rehabilitation can be optimized by selecting the movements to be practiced based on the trainee’s performance profile. Methods We present a novel principle (‘steepest gradients’) for performance-based selection of movements. The principle is based on mapping motor performance across a workspace and then selecting movements located at regions of the steepest transition between better and worse performance. To assess the benefit of this principle we compared the effect of 15 sessions of robot-assisted reaching training on upper-limb motor impairment, between two groups of people who have moderate-to-severe chronic upper-limb hemiparesis due to stroke. The test group (N = 7) received steepest gradients-based training, iteratively selected according to the steepest gradients principle with weekly remapping, whereas the control group (N = 9) received a standard “centre-out” reaching training. Training intensity was identical. Results Both groups showed improvement in Fugl-Meyer upper-extremity scores (the primary outcome measure). Moreover, the test group showed significantly greater improvement (twofold) compared to control. The score remained elevated, on average, for at least 4 weeks although the additional benefit of the steepest-gradients -based training diminished relative to control. Conclusions This study provides a proof of concept for the superior benefit of performance-based selection of practiced movements in reducing upper-limb motor impairment due to stroke. This added benefit was most evident in the short term, suggesting that performance-based steepest-gradients training may be effective in increasing the rate of initial phase of practice-based recovery; we discuss how long-term retention may also be improved. Trial registration ISRCTN, ISRCTN65226825, registered 12 June 2018 - Retrospectively registered, Electronic supplementary material The online version of this article (10.1186/s12984-019-0513-0) contains supplementary material, which is available to authorized users.
Europe PubMed Centra... arrow_drop_down Europe PubMed CentralArticle . 2019Full-Text: http://europepmc.org/articles/PMC6466732Data sources: PubMed CentralJournal of NeuroEngineering and RehabilitationArticle . 2019Full-Text: http://europepmc.org/articles/PMC6425657Data sources: PubMed CentralJournal of NeuroEngineering and RehabilitationArticle . 2019 . Peer-reviewedLicense: CC BYData sources: Crossrefadd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.All Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=10.1186/s12984-019-0521-0&type=result"></script>'); --> </script>
For further information contact us at helpdesk@openaire.euAccess Routesgold 8 citations 8 popularity Top 10% influence Average impulse Top 10% Powered by BIP!more_vert Europe PubMed Centra... arrow_drop_down Europe PubMed CentralArticle . 2019Full-Text: http://europepmc.org/articles/PMC6466732Data sources: PubMed CentralJournal of NeuroEngineering and RehabilitationArticle . 2019Full-Text: http://europepmc.org/articles/PMC6425657Data sources: PubMed CentralJournal of NeuroEngineering and RehabilitationArticle . 2019 . Peer-reviewedLicense: CC BYData sources: Crossrefadd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.All Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=10.1186/s12984-019-0521-0&type=result"></script>'); --> </script>
For further information contact us at helpdesk@openaire.eudescription Publicationkeyboard_double_arrow_right Article 2017Funded by:WT | Cerebellar-cortical inter..., UKRI | Performance-based selecti..., WT | Institutional Strategic S... +1 projectsWT| Cerebellar-cortical interactions in health, aging and disease. ,UKRI| Performance-based selective training for robot-mediated upper limb motor learning and stroke rehabilitation ,WT| Institutional Strategic Support Fund Phase2 FY2014/16 ,UKRI| University of Birmingham Confidence in ConceptOrna, Rosenthal; Alan M, Wing; Jeremy L, Wyatt; David, Punt; R Chris, Miall;pmid: 29208020
pmc: PMC5718133
Background Chronic upper limb motor impairment is a common outcome of stroke. Therapeutic training can reduce motor impairment. Recently, a growing interest in evaluating motor training provided by robotic assistive devices has emerged. Robot-assisted therapy is attractive because it provides a means of increasing practice intensity without increasing the workload of physical therapists. However, movements practised through robotic assistive devices are commonly pre-defined and fixed across individuals. More optimal training may result from individualizing the selection of the trained movements based on the individual’s impairment profile. This requires quantitative assessment of the degree of the motor impairment prior to training, in relevant movement tasks. However, standard clinical measures for profiling motor impairment after stroke are often subjective and lack precision. We have developed a novel robot-mediated method for systematic and fine-grained mapping (or profiling) of individual performance across a wide range of planar arm reaching movements. Here we describe and demonstrate this mapping method and its utilization for individualized training. We also present a novel principle for the individualized selection of training movements based on the performance maps. Methods and Results To demonstrate the utility of our method we present examples of 2D performance maps produced from the kinetic and kinematics data of two individuals with stroke-related upper limb hemiparesis. The maps outline distinct regions of high motor impairment. The procedure of map-based selection of training movements and the change in motor performance following training is demonstrated for one participant. Conclusions The performance mapping method is feasible to produce (online or offline). The 2D maps are easy to interpret and to be utilized for selecting individual performance-based training. Different performance maps can be easily compared within and between individuals, which potentially has diagnostic utility. Electronic supplementary material The online version of this article (10.1186/s12984-017-0335-x) contains supplementary material, which is available to authorized users.
Europe PubMed Centra... arrow_drop_down Europe PubMed CentralArticle . 2017Full-Text: http://europepmc.org/articles/PMC5718133Data sources: PubMed Centraladd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.All Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=PMC5718133&type=result"></script>'); --> </script>
For further information contact us at helpdesk@openaire.eu1 citations 1 popularity Average influence Average impulse Average Powered by BIP!visibility 1visibility views 1 Powered bymore_vert Europe PubMed Centra... arrow_drop_down Europe PubMed CentralArticle . 2017Full-Text: http://europepmc.org/articles/PMC5718133Data sources: PubMed Centraladd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.All Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=PMC5718133&type=result"></script>'); --> </script>
For further information contact us at helpdesk@openaire.eu